| NPI | 1740233949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 26721) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: SC 2566) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2010-11-11 |